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Buprenorphine, sold under the brand name Subutex among others, is an opioid used to treat opioid use disorder, acute pain, and chronic pain. [18] It can be used under the tongue (sublingual), in the cheek (buccal), by injection (intravenous and subcutaneous), as a skin patch (transdermal), or as an implant.
Buprenorphine/naloxone, sold under the brand name Suboxone among others, is a fixed-dose combination medication that includes buprenorphine and naloxone. [3] It is used to treat opioid use disorder , and reduces the mortality of opioid use disorder by 50% (by reducing the risk of overdose on full-agonist opioids such as heroin or fentanyl ).
Opioid agonist therapy (OAT) is a treatment in which prescribed opioid agonists are given to patients who live with Opioid use disorder (OUD). [1] In the case of methadone maintenance treatment (MMT), methadone is used to treat dependence on heroin or other opioids, and is administered on an ongoing basis.
To become certified to prescribe buprenorphine, doctors have to first complete a one-day training class on addiction medicine. Then, for the first year of prescribing buprenorphine, certified doctors are limited to accepting only 30 patients with opioid addiction at any one time. They can move up to 100 patients in their second year of prescribing.
It has been found to produce antidepressant-like effects in mice (similarly to the case of buprenorphine alone or in combination with samidorphan) [3] [4] and (at a buprenorphine dosage of 16 mg/day but not 4 mg/day) has recently been found to be effective in the treatment of cocaine dependence in a large clinical trial. [5] [6]
Karyn Hascal, The Healing Place’s president and CEO, said she would never allow Suboxone in her treatment program because her 12-step curriculum is “a drug-free model. There’s kind of a conflict between drug-free and Suboxone.” For policymakers, denying addicts the best scientifically proven treatment carries no political cost.
Buprenorphine-3-glucuronide (B3G) is a major active metabolite of the opioid modulator buprenorphine. [1] It has affinity for the μ-opioid receptor (K i = 4.9 (± 2.7) pM), δ-opioid receptor (K i = 270 nM), and nociceptin receptor (K i = 36 μM), but not for the κ-opioid receptor. [1]
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